Research aims to find ‘sweet spot’ for pertussis vaccination

Research aims to find ‘sweet spot’ for pertussis
vaccination in babies

The pertussis (whooping cough)
vaccine given to infants at six weeks of age will be tested
for its effectiveness in babies whose mums were vaccinated
during pregnancy.

A University of Auckland researcher
suspects that antibodies passed on from mother to baby might
interfere with an infant’s primary immune response when
receiving their first pertussis vaccine, which in New
Zealand happens at six weeks old.

Dr Helen
Petousis-Harris has just been awarded a $210,000 grant from
PHARMAC and the Health Research Council of New Zealand (HRC)
to test the protective effect that maternal vaccination
offers against whooping cough, taking into account the
additive overall effect of baby’s own first vaccine.

In most other high-income countries, the vaccine is given
at eight weeks of age and there is evidence to show that at
that age, combined with maternal vaccination, it offers
additional protection in infants. But a major question
remains around the additive benefit or risk posed by
immunisation at an earlier age, says Dr Petousis-Harris.

“Giving vaccines to pregnant women is a very effective
way to protect babies in their first weeks of life and many
countries have adopted this strategy. But we might be able
to improve the effectiveness even more by looking at how we
time things,” she says.

“Somewhere there is a
sweet spot where the benefits of both maternal and infant
immunisation can be maximised.”

Her findings will
inform the National Immunisation Schedule and could affect
when infants are first given their pertussis vaccine.

PHARMAC medical director, Dr John Wyeth says that PHARMAC
is pleased to support this research.

“The aim of our
partnership with the Health Research Council is to support
research that helps people get the best out of medicines
that are funded. There are significant benefits to New
Zealand from making the best use of pertussis vaccine, and
understanding the optimal timing of vaccination. This
research could ultimately inform how this vaccine is funded
for babies in future, and help healthcare professionals and
patients make well-informed decisions,” says Dr Wyeth.

Another newly-funded study under the PHARMAC-HRC
partnership involves the development of a decision aid to
help rheumatoid arthritis patients make choices about
treatment.

Biologics are drugs that specifically
target the inflammatory pathways that cause joint
inflammation, the critical clinical factor in rheumatoid
arthritis. They have revolutionised management of the
condition, but they do come with adverse effects and a hefty
price tag, says grant recipient, Professor Carlo Marra from
the University of Otago.

Recent data suggests that
some people who have a good response to these agents can
actually stop using them and still keep their rheumatoid
arthritis in check. However, some will relapse and have
their arthritis symptoms return when stopping the
treatment.

Helping patients choose whether to taper
off their treatment (or continue with it) once remission has
been achieved, is the point of the decision tool, says
Professor Marra.

“Patients have to decide whether
they want to risk having an arthritis flare against the
prospect of being free of potentially toxic medications,”
he says. “This tool helps them understand the options
available, including their harms and benefits, and
individually weigh each according to their
values.”

HRC chief executive Professor Kath
McPherson says innovations like an effective decision aid
not only help people take more control over their health and
wellbeing decisions, but should help ensure medicines are
used as and when they’re needed.

“Both of these
projects offer a fresh look into how people can most
effectively use the treatments available to them, to
optimise the potential benefit.”

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